Percutaneous screw fixation of fractured neck of femur in a teenage girl with osteogenesis imperfecta. A case report

• Published in: International journal of surgery case reports 2018-01, Vol.49, p.170-175
• Main Authors: Alkhateeb, Jawaher Mohammed, Aljawder, Abdulla Anwar, Alabbasi, Fawaz Abdulrahim
• Format: Article
• Language: English
• Subjects: Case report; Fractured femur neck; Fragility fracture; Osteogenesis imperfecta; Percutaneous screw fixation; Surgical fixation
• ISSN: 2210-2612; 2210-2612
• DOI: 10.1016/j.ijscr.2018.06.039

•Patients with osteogenesisis imperfecta suffer from repeated fractures, skeletal deformities, and functional limitations.•Neck of femur fracture in small abnormal hips is difficult to manage.•Controlling pain and return to pre-fracture functional status are the primary goal of surgical management.•Percutaneous screw fixation of fractured neck of femur proved to provide successful outcomes in patients with osteogenesis imperfecta. Neck of femur fracture in osteogenesis imperfecta is rarely reported. The management is uncertain and always reported as difficult. Clinical outcomes are not well described. A teenage girl, who is known to have osteogenesis imperfecta, sustained neck of femur fracture in the presence of a previously inserted implant. She was treated by percutaneous screw fixation. In both immediate and long term follow up, our patient had satisfactory outcome and return to pre-fracture functional status. Dealing with fragility fracture in small abnormal hips is challenging especially, in the presence of a retained implant in- situ. Intra-operative difficulty were encountered during positioning, reduction, and screw insertion attempt. This rare case illustrates the anticipated difficulties in managing neck of femur fracture in osteogenesis imperfect patients. It also emphasize on the importance of surgical fixation to control pain and allow for healing in anatomically functional position.